Donor kidneys from Hepatitis C patients needlessly denied to patients with that infection

Apr 01, 2010

More than half of donor kidneys in the United State infected with hepatitis C are thrown away, despite the need among hepatitis C patients who may die waiting for an infection-free organ, Johns Hopkins research suggests.

In a study of national data published online in the American Journal of Transplantation, the researchers say that while outcomes are slightly worse when hepatitis C-positive patients receive hepatitis C-positive organs, the advantages of more timely transplants may outweigh the risk of waiting — perhaps more than year — for a hepatitis C-negative kidney.

Patients with hepatitis C-positive make up about 12 percent of the population with kidney failure, and those patients have an increased risk of death on dialysis compared with those without the virus, the study says.

"Nationwide, kidneys from infected donors are inappropriately thrown out and denied to patients in need," says transplant surgeon Dorry L. Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine and the study's leader. "Many transplant centers don't use these kidneys at all, effectively consigning hepatitis C-positive patients to an average unnecessary wait of a year longer for an uninfected organ."

That, he says, "means an extra year on dialysis, in which the risk of death is 10 to 15 percent."

The use of hepatitis C-positive kidneys has been controversial in the past, owing in part to a 1 percent difference in one-year survival for patients who receive the infected kidneys and a 2 percent difference in three-year survival. Segev says this difference "is easily made up for by getting off dialysis sooner."

Hepatitis C-positive kidneys rarely go to hepatitis C-negative patients because the organ would infect the recipient with the chronic liver disease.

In looking at data from more than 93,000 deceased kidney donors between 1995 and 2009, Segev and his colleagues found that hepatitis C-positive kidneys were two and a half times more likely to be discarded than hepatitis C-negative kidneys. Since 1995, more than 3,500 hepatitis C-positive kidneys were thrown away.

"That's a lot of kidneys we could have transplanted into people who need them," Segev says.

Meanwhile, he adds, some 4,800 hepatitis C patients got hepatitis C-negative kidneys. "Using hepatitis C-positive kidneys in people who are infected with the virus could help those with hepatitis C and also expand the organ supply for everyone."

One-third of the nation's transplant centers, according to the study, did not use any hepatitis C-positive kidneys for their hepatitis C patients, while 13 percent transplanted more than half of their hepatitis C patients with hepatitis C-positive kidneys.

At The Johns Hopkins Hospital, where doctors specialize in patients with hepatitis C and kidney failure, a patient with hepatitis C could likely be successfully transplanted with a hepatitis C-positive kidney within several months of being put on the waiting list, Segev says. Recipients of hepatitis C-positive kidneys waited, on average, 395 days less than those recipients who waited for hepatitis C-negative kidneys at the same transplant center, the study shows.

Related Stories

One-third of people over the age of 65 wait longer than necessary for lifesaving, new kidneys because their doctors fail to put them in a queue for organs unsuitable to transplant in younger patients but well-suited to seniors, ...

A Johns Hopkins study finds that HIV-positive kidney transplant recipients could have the same one-year survival rates for themselves and their donor organs as those without HIV, provided certain risk factors for transplant ...

The use of peginterferon alone, or in combination with ribavirin, points to a cure for hepatitis C, the leading cause of cirrhosis, liver cancer and the need for liver transplant, a Virginia Commonwealth University researcher ...

ZMapp, the experimental Ebola drug that won notoriety when it was given to a handful of infected aid workers at the height of the epidemic, will now begin clinical testing in Liberian treatment centers, U.S. health authorities ...

Public health experts can identify nations that are vulnerable to the occurrence and impact of future outbreaks of Ebola or other emergencies by using a screening tool that evaluates a nation's strengths across a wide range ...

Vienna's public lavatories were at the focus of a study by the Global Food Safety research group at the Vetmeduni Vienna. The researchers studied 224 public restrooms in Vienna, which are about 91 percent ...

Known for years as the "career woman's disease" based on the idea that women without children develop disease in their reproductive organs, endometriosis is a painful condition thought to affect one in ten wome ...

User comments : 0

Please sign in to add a comment.
Registration is free, and takes less than a minute.
Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.

Javascript is currently disabled in your web browser. For full site functionality, it is necessary to enable Javascript.
In order to enable it, please see these instructions.